How do I help my teen's anxiety?

I have a 16-year-old daughter who suffers terribly with anxiety and depression.

This all started four years ago when she was bullied so badly that we moved schools where she had similar problems. We've been home schooling ever since.

She's always felt left out and found it difficult to make friends. She relies on meeting people through Facebook and then going out clubbing with them as virtual strangers. She's been diagnosed with Acute Anxiety Disorder but is desperate to have a 'normal' teen life like her brother who's 18.

In order to boost her confidence she drinks alcohol and then goes clubbing using false ID as she feels this is the only way she can have any sort of a social life. Obviously I don't approve of this at all and her mum and I have tried to talk to her many, many times about the danger she's putting herself in but she's so unhappy that she won't listen.

I now find myself driving around at 3am to pick her up from being out just so she gets home safely. I can't lock her up but the arguments and the stress it's placing on the rest of the family are getting worse. I don't even know where to begin to solve this.

Dr Justin says:

There are several significant issues that need to be addressed, one at a time, to help your family get through what is a difficult time. They include your daughter’s loneliness and depression, her anxiety related to the bullying, her reliance on alcohol to be social, and your need to work together to set appropriate limits on behaviour.

Loneliness, depression and anxiety in children

As children experience the challenges that life – and particularly school – throw at them, some fare better than others. Sometimes life can be a lottery, and other times we create challenges for ourselves. Whatever the reason, your daughter has found herself on the receiving end of significant bullying. There is a lot of research that indicates that her current anxiety and depression are likely to be related, at least in part, to the social difficulties she has faced and the way in which she has (and you as a family have) responded to those difficulties. We need to find strategies and ideas for building your daughter’s resilience (her ability to bounce back from difficulties), and ideas to increase her wellbeing and release her from her depressive behaviours and cognitions.

Reliance on alcohol in teens

The perceived motivation that your daughter has for turning to alcohol suggests the formation of an unhelpful – and ultimately destructive – habit. Alcohol has a powerful effect on the developing brain (and your daughter has at least a few years of brain development to go). As a depressant it can impact on her already arguably depressed state and can lead to a reinforcement of her feelings of low self-worth. This and other factors can ultimately lead to a reliance on drinking unless new habits of thought and behaviour can be developed.

Setting limits for kids

Your daughter is on her way to being an ‘adult’ now. As a result of her increasing independence and maturity (or at least her identity development and separation from her parents) she is now less likely to receive influence from you than perhaps at any other time in her life. While this will ultimately pass, it makes your role as her (very concerned) parent so much harder. In these circumstances it is typical of parents to want to push and coerce their teenage children into doing as they’re told. But as you've discovered, your daughter is resistant to your influence. So we need to describe effective ways that you can work together to define appropriate and helpful ways for her to act.

The solution

Situations such as this require long-term, complex strategies. I cannot give you a comprehensive overview of how to manage this situation from go to whoa. But I will suggest some ideas and principles that can make a difference. As your daughter’s parent, you have the capacity to discern what she needs, and with patience and kindness (and more patience), you will help her.

Your daughter needs to strengthen her relationship with important adults in her life. That may be you or her mum. It may be a grandparent, a coach, a church teacher, an aunt, or an adult who she loves and feels loved by. I would suggest that she spend a LOT of time with that person; walking, talking, cooking, playing sport, whatever it is that they do together. As your daughter develops and strengthens positive relationships with one or two (or three) adults who are crazy about her, she will experience feelings of self-worth. She’ll also likely feel safe enough to talk about her difficulties and consider possible solutions (but don’t rush this … let it happen naturally).

As relationships between your daughter and you, as her parent(s), are strengthened, I recommend that you gently ask her to work with you on creating a plan for the future. What does she value? When does she feel ‘strong’? (What are her strengths?) How can she turn her values (feelings about what’s important) into goals (concrete commitments to do something by a certain time)? How can you help her to achieve those goals? Sometimes a life coach can be useful for this kind of work. (Life coaches will not do so much for anxiety and depression – for that, you need a psychologist). By creating a PLAN for the future your daughter can have something positive to work towards in her life. She may develop optimism, resilience, gritty determination. The plan has to evolve slowly and be detailed. It should list specific actions that need to be completed daily or weekly to achieve those goals. And she has to really WANT those goals. But with this kind of direction in her life, she is more likely to make good choices.

Socially, your daughter may need some help. Nightclubs, however, are not the most useful place to meet people looking to develop meaningful relationships. What are your daughter’s interests? Perhaps there is a club or society or other organisation where people who like the same things go? Becoming a member of an organisation with other like-minded people can be a helpful start to creating new relationships. As parents you might foster her relationships with old friends by inviting them to your home, having dinner parties or a surprise party, and so on. Look for opportunities for your daughter to try new hobbies (indoor rock-climbing, chess, bowls, craft – I’m guessing here, but you can develop ideas with her) and get her involved.

Setting limits is the toughest item on this list. You can no longer force your daughter to do as you say. (Well you can, but it will damage your relationship badly.) Instead, your relationship will do better if you slowly and patiently discuss ways that you can agree and work together on the development of appropriate limits to behaviour. Going to nightclubs with false ID, and underage drinking, regardless of how common, are habits that have to change. Forcing change will be nearly impossible. Instead, intelligent, compassionate, patient conversations should be shared about what is appropriate behaviour and what is not. Ask your daughter lots of questions about her situation, the ramifications of her choices, and what she thinks the BEST answers are. Let her guide and influence the conversation. Your job is to gently bring her to appropriate solutions. Set limits that respect her growing independence and maturity, and that allow her to get things she wants in ways that you feel good about.

A couple of warnings

Two things to keep in mind amid all of this:

First, your daughter is still developing and will continue to do so for several years yet. Her ability to look into the future and perceive accurately is limited, especially when she is emotional. For her, the future is this weekend, or the upcoming holiday. Imagining life at 24 or 35 is nearly impossible. While she functions in many ways like an adult now, this is one severely limiting factor to keep in mind in your discussions.

Second, your anxiety for your daughter’s welfare can easily and naturally lead to a coercive approach. When she argues, behaves unreasonably, and will not ‘buy’ into your suggestions it can be easy to try and force her to do as she’s told. Such a response will be counter-productive. If she is unwilling to listen and interact, it is better to work on protecting the relationship. Say something like, “OK, I just thought this might be something to consider. Maybe we can chat about it later.” Leave it as a ‘thought-starter’ and let it go. As you build your relationship first, trust will increase and openness to your influence will also build.

These challenges and the small handful of strategies I’ve suggested are unlikely to be resolved quickly. Any quick-fix will likely be undone just as quickly. Rather, building on a strong relationship foundation of trust and openness (both ways) will promote lasting change.

This article was written for Kidspot by Justin Coulson, Ph. D. Justin is a relationships and parenting expert, author and father of five children. Find him on Facebook, Twitter, and at happyfamilies.com.au.